Wise to heed doctor advice: AMA

December 25, 2013

Patients have been urged to heed their doctor’s advice to undertake tests, treatments, referrals and follow-up appointments.

In the face of concerns that some patients are putting their health at risk by ignoring recommendations for further tests, to see a specialists or to make a follow-up appointment, the AMA has issued a Position Statement outlining the responsibilities of both doctors and patients in providing care.

AMA Vice President Professor Geoffrey Dobb said doctors needed to have systems in place to ensure that any referrals for pathology tests, radiology procedures, and other diagnostic tests were properly initiated and acted upon, and that the results were conveyed in a timely manner.

Professor Dobb said these systems, including mechanisms for effective follow-up, recall and reminders, were vital for the provision of high-quality care.

But he said patients also had a role to play.

“While doctors have a duty of care to their patients, patients are encouraged to actively participate in their own health care,” Professor Dobb said. “They must be honest with their doctor regarding their own health, make informed health care decisions, and undertake recommended treatments, tests, referrals, follow-up appointments and reminder appointments.”

The AMA said that, of course, patients had the right to decline to follow their doctor’s advice, but they should do so fully informed of the possible consequences of their decision.

In its Position Statement on Patient Follow-Up, Recall, and Reminder Systems 2013, the Association said a patient’s informed choice should be respected, but added doctors should advise patients of the benefits and risks of not undertaking a recommended test or following up a referral.

“Where a patient indicates they do not intend to comply with the doctor’s recommendation, the doctor should record the discussion in the patient’s medical record, including the reasons given by the patients, if any, for not following the advice,” it said.

Additionally, doctors should make “a reasonable attempt” to contact patients who have had a clinically significant test result or diagnosis, but have not attended a follow-up appointment.

The Position Statement said how substantial these efforts should be depended on judgements about the seriousness of the medical condition, the risk of delay in receiving treatment, and the significance or abnormality of any tests or reports.

Professor Dobb said that though the informed decisions of patients should be respected, this meant they also carried responsibility for the consequences of their decision.

“While patients have the right not to attend recommended tests, referrals, follow-up, or recall appointments, with this right comes the responsibility for the consequences of that properly informed decision to follow or reject their doctor’s advice,” he said.

Professor Dobb added that medical facilities, including hospitals and medical practices, “should support patients, doctors, and other health care professionals by having effective and accountable systems for patient follow-up, recall, and reminders”.